RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining chemotherapy with peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. It is not yet known which therapy regimen is most effective for treating patients with kidney tumors.

PURPOSE: Phase III trial to compare the effectiveness of chemotherapy with or without radiation therapy, surgery, and/or peripheral stem cell or bone marrow transplantation in treating young patients with kidney tumors.

To determine the two-year second event-free survival percentage for children who relapse following initial therapy with nephrectomy only following treatment with vincristine and dactinomycin, with or without doxorubicin, depending upon the site of relapse and presence or absence of microscopic residual disease.

To determine if the two-year second event-free survival percentage for children who relapse following initial treatment with Regimen EE-4A who do not have loss of heterozygosity of markers for chromosome 16q, 1p or increased DNA content in tumor cells is not less than 40% higher than that of similar patients who have loss of heterozygosity for chromosome 16q, 1p or increased DNA content following treatment with intensive chemotherapy using doxorubicin, etoposide, cyclophosphamide and carboplatin, and radiation therapy to sites of microscopic or gross residual disease.

To determine if the four-year post-relapse survival percentage for children who relapse following initial treatment with Regimen DD - 4A who do not have loss of heterozygosity of markers for chromosome 16q, 1p or increased DNA content in tumor cells is not less than 40% higher than that of similar patients who have loss of heterozygosity for chromosome 16q, 1p or increased DNA content following treatment with intensive chemotherapy using etoposide, cyclophosphamide and carboplatin.

Response rate [ Designated as safety issue: No ]

To determine if the response rate (CR + PR) of clear cell sarcoma of the kidney and diffuse anaplastic Wilms tumor to the combination of carboplatin and etoposide each exceed 20%.

Treatment of children in Stratum A will be determined by the site of relapse and the presence of microscopic or gross residual disease after attempted surgical excision of the relapse.

Biological: dactinomycin

Other Names:

Actinomycin-D

Cosmegen

NSC #3053

Drug: doxorubicin hydrochloride

Other Names:

Adriamycin

NSC #123127

Drug: vincristine sulfate

IV

Other Name: VCR

Procedure: conventional surgery
Radiation: radiation therapy

Experimental: Stratum B

All children who received combination chemotherapy with Regimen EE - 4A as their initial therapy for Wilms tumor will receive Regimen I and radiation therapy to the site of recurrence. All patients will receive prophylactic trimethoprim /sulfamethoxazole

Biological: filgrastim

Other Names:

Granulocyte-colony stimulating factor

r-MetHuG-CSF

GCSF

Neupogen

NSC #614629

Drug: cyclophosphamide

Other Names:

CTX

Cytoxan

NSC #2626-71

Drug: doxorubicin hydrochloride

Other Names:

Adriamycin

NSC #123127

Drug: etoposide

Other Names:

VP-16

VePesid

NSC #141540

Drug: vincristine sulfate

IV

Other Name: VCR

Procedure: conventional surgery
Radiation: radiation therapy

Experimental: STRATUM C

All children who received combination chemotherapy with Regimen DD - 4A as their initial therapy for Wilms tumor will be treated with the following chemotherapy. All patients will receive prophylactic trimethoprim/sulfamethoxazole

Biological: filgrastim

Other Names:

Granulocyte-colony stimulating factor

r-MetHuG-CSF

GCSF

Neupogen

NSC #614629

Drug: carboplatin

Other Names:

CBDCA

NSC #241240

Drug: cyclophosphamide

Other Names:

CTX

Cytoxan

NSC #2626-71

Drug: etoposide

Other Names:

VP-16

VePesid

NSC #141540

Procedure: conventional surgery
Radiation: radiation therapy

Experimental: STRATUM D

Six week cycles of chemotherapy will be given to all patients who do not have progressive disease at the time of each week 0 re-evaluation.

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Please refer to this study by its ClinicalTrials.gov identifier: NCT00002610